急性心肌梗死患者血清MMP-9与冠状动脉疾病严重性及预后的关系

目的探讨血清基质金属蛋白酶-9(MMP-9)水平与急性心肌梗死(AMI)患者冠状动脉疾病严重性及预后的关系。方法选取AMI患者87例,在急诊经皮穿刺冠脉内介入术(PCI)后根据冠脉造影结果分为1支、2支和3支病变组,正常对照组30例。对照组于清晨空腹,AMI患者于PCI术前采血,采用ELISA法测定MMP-9,随访其心血管事件半年。结果 AMI患者PCI术前血清MMP-9水平在3支病变组均显著高于2支、1支病变组、对照组;在2支、1支病变组显著高于对照组;经随访,25例发生心血管事件,3支病变组心血管事件发生率显著高于2支、1支病变组;以血清MMP-9水平846μg/L为界分为A组和B组,A组心血管事件发生率显著高于B组。结论 AMI患者血清MMP-9可能用于评价冠状动脉疾病严重性,并对冠脉支架置入术后的心血管事件的发生有预测价值。

The relationship between matrix metalloproteinase-9 after acute myocardial infarction and the severity of coronary artery disease as well as prognosis

Objective To investigate the relationship between serum concentration of matrix metalloproteinase-9(MMP-9) in the patients with acute myocardial infarction(AMI)and the severity of coronary artery disease as well as prognosis.Methods Eighty seven patients with AMI which received percutaneous coronary intervention(PCI) were divided into three groups: 1-vessel AMI,2-vessel AMI and 3-vessel AMI according to angiography assessment of coronary arteries,and 30 controls.We determined the serum concentration of MMP-9 before PCI treatment in the AMI patients and in the controls using ELISA.Patients were followed-up for half a year.Results Serum MMP-9 concentration was significantly higher in the patients with 3-vessel AMI than in those with 1-or 2-vessel AMI or in the controls.Serum MMP-9 concentration was also significantly higher in the patients with 1-or 2-vessel AMI than in the controls.In the follow-up,27 patients had 13 cardiac events.The ratios of cardiac events were higher in 3-vessel AMI group than that in the 1-or 2-vessel AMI group.Group A and group B were classified based on serum concentration of MMP-9(846μg/L).The ratios of cardiac events in group A were higher than that in group B.Conclusion The serum concentration of MMP-9 may be useful in the evaluation of the severity of coronary artery disease,the serum concentration of MMP-9 may have predictive value in prognosis of patients with AMI.